U.S. patent number 6,086,590 [Application Number 09/241,980] was granted by the patent office on 2000-07-11 for cable connector for orthopaedic rod.
This patent grant is currently assigned to Pioneer Laboratories, Inc.. Invention is credited to Francis J. Korhonen, Joseph Y. Margulies, Matthew N. Songer.
United States Patent |
6,086,590 |
Margulies , et al. |
July 11, 2000 |
Cable connector for orthopaedic rod
Abstract
A connector for securing surgical cable or wire to an
implantable surgical rod or the like. The connector comprises a
connector body having an open space for receiving the surgical rod
or similar support device. The body carries a lock member for
firmly affixing the connector and the rod together in a desired
position along the rod. Typically, the lock member is a set screw.
The connector also has a retention member carried on the connector
in a rotatable manner. The retention member, typically in ring
form, defines at least one bore extending there through for
receiving the cable or wire, and retaining it in a desired position
relative to the rod. Thus, tension can be placed upon broken bones
or the like from a desired, controllable direction and with a
desired magnitude of tension.
Inventors: |
Margulies; Joseph Y. (Armonk,
NY), Songer; Matthew N. (Marquette, MI), Korhonen;
Francis J. (Neqaunee, MI) |
Assignee: |
Pioneer Laboratories, Inc.
(Marquette, MI)
|
Family
ID: |
22912979 |
Appl.
No.: |
09/241,980 |
Filed: |
February 2, 1999 |
Current U.S.
Class: |
606/263; 606/278;
606/279; 606/328; 606/74 |
Current CPC
Class: |
A61B
17/842 (20130101); A61B 17/7053 (20130101) |
Current International
Class: |
A61B
17/84 (20060101); A61B 17/68 (20060101); A61B
17/70 (20060101); A61B 017/58 () |
Field of
Search: |
;606/74,72,73,61 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Buiz; Michael
Assistant Examiner: Woo; Julian W.
Attorney, Agent or Firm: Gerstman; George H. Ellis;
Garrettson
Claims
We claim:
1. A connector for securing surgical cable or wire to an
implantable surgical rod, which connector comprises:
A connector body having an open space for receiving a surgical rod,
said body carrying a lock member for firmly affixing the connector
and the rod together in a desired position along the rod, said
connector also having a retention member carried on said connector
in a rotatable manner, said retention member defining at least one
bore extending therethrough for receiving said cable or wire, and
retaining it in a desired position relative to said rod.
2. The connector of claim 1 in which said retention member is a
rotatable ring.
3. The connector of claim 1 in which said open space is a hole
extending through said connector body.
4. The connector of claim 1 in which said open space is a recess
partially surrounded by a hook member of said body.
5. The connector of claim 1 in which said rotatable member defines
a plurality of spaced bores for receiving said cable or wire.
6. The connector of claim 1 in which the lock member is a set
screw.
7. The connector of claim 6 in which the set screw defines an outer
head having an outwardly extending retention flange, said retention
member comprising a rotatable ring positioned about said set screw
between said connector body and the retention flange.
8. A connector for securing a surgical cable or wire to an
implantable surgical rod, which connector comprises a connector
body having an open space for receiving an orthopaedic rod, said
body carrying a set screw for firmly affixing the connector and the
rod together in a desired position along the rod, said connector
also having a rotatable retention ring carried on said connector in
a rotatable manner, said retention ring defining at least one bore
extending therethrough for receiving said cable or wire, and
retaining it in a desired position relative to said rod.
9. The connector of claim 8 in which said at least one bore extends
in a direction transverse to the axis of the orthopaedic rod when
the connector is secured thereto.
10. The connector of claim 8 in which said rotatable retention ring
defines a plurality of spaced bores for receiving said cable or
wire.
11. The connector of claim 10 in which said set screw defines an
outer head having an outwardly extending retention flange, said
rotatable retention ring being positioned about said set screw
between the connector body and the retention flange.
12. The connector of claim 11 in which said open space is a hole
extending through said connector body.
13. The connector of claim 12 in said open space is partially
surrounded by a hook member of said body.
14. The surgical method of compressing or distracting bone
portions, which comprises:
emplacing a surgical rod in a patient; placing wire or cable around
said bone portions; placing a connector into engagement with said
rod and with said wire or cable; tightening said wire or cable into
a retained position with said bone and said connector including the
step of at least one of: (1) sliding said connector along said
surgical rod and (2) rotating the wire or cable engaging said
connector to position said wire or cable to compress, distract, or
rotate said bone portions in a desired manner; tightly securing
said connector to the surgical rod; and tightly securing said wire
or cable to the connector.
15. The method of claim 14 in which said wire or cable is secured
to a rotatable portion of said connector.
16. A connector for securing surgical cable or wire to an
implantable surgical support device, which connector comprises: a
connector body configured for being secured to said implantable
support device, said body carrying a lock for firmly affixing the
connector and the implantable support device together in an
adjustably selected position with respect to the support device,
said connector also having a retention member carried on the
connector for receiving said cable or wire and retaining it in a
desired position relative to said implantable support device.
17. A connector for securing surgical cable or wire which connector
comprises:
a connector body having a fitment for connecting to a
patient-implantable device in firmly locked manner, said connector
body also having a retention member comprising at least one of an
aperture or a groove for receiving said cable or wire and retaining
it in a desired position relative to said patient implantable
device.
18. The connector of claim 17 in which said retention member
comprises an annular groove.
19. The connector of claim 18 in which said retention member
comprises a first annular groove, plus a second annular groove
positioned transversely of the first annular groove.
20. The connector of claim 17 in which said patient-implantable
device is a rod.
21. The connector of claim 17 in which the patient-implantable
device is a prosthesis for a joint.
22. The connector of claim 17 in which said cable or wire is for
securing a bone to said connector.
23. The connector of claim 17 in which said cable or wire is for
securing a patient-implantable device to said connector.
24. The connector of claim 17 in which said retention member is
carried on said connector in rotatable manner and defines at least
one bore extending therethrough for receiving said cable or wire
and retaining it in said desired position.
Description
BACKGROUND OF THE INVENTION
Orthopaedic rods are commonly used to support the spine where
necessary in orthopaedic surgery as one major use. Surgical wire
and cable is then wrapped around the adjacent bones that need extra
support, the wire or cable then being wrapped around the
orthopaedic rod.
In the prior art, there is a problem of controlling cable or wire
directions in its attachment to the orthopaedic rod.
Conventionally, one can gain directional control with a pedicle
screw, and to a certain extent with a hook claw. However, a hook
claw can give control in one direction only, namely the direction
of its blade. Thus, in the prior art, there are problems during and
after surgery in that control of the wire orientation is somewhat
limited.
By this invention, surgical cable or wire can be connected to a
surgical rod in a way that will allow pulling or pushing, as well
as solid cranial-caudal axial and rotational control in a manner
that is significantly improved over the prior art.
DESCRIPTION OF THE INVENTION
By this invention, a connector is provided for securing surgical
cable or wire to an implantable surgical rod or other
patient-implantable device. The connector comprises a connector
body typically having an open space for receiving an orthopaedic
rod. This space may be an aperture, or a recess which is open at
the side defined by what is commonly called a hook. The connector
body carries a lock member such as a set screw for firmly affixing
the connector and the rod together in a desired position along the
rod.
The connector also has a retention member which is carried on the
connector in a rotatable manner. The retention member defines at
least one bore which extends therethrough for receiving the cable
or wire which is to be attached to the surgical rod, and retaining
such cable or wire in a desired position relative to the rod, and
also to the bones which the surgical cable or wire is provided to
secure.
Typically, the retention member is a rotatable ring having a bore
extending through it to receive the cable and wire as described
above. A plurality of such bores may be provided, for example two,
as shown in the specific embodiment.
When the locking member is a set screw, as shown in the specific
embodiment, the set screw may define an outer head having an
outwardly extending retention flange. Thus, the retention member
may comprise a rotatable ring which is rotatably positioned and
held about the set screw between the connector body and the
retention flange.
When cable is being implanted around bone and being secured to an
implantable rod, the connector may be moved along the rod to a
desired position where the direction of tension of the cable is
optimum for the situation in question. Then, the connector may be
firmly attached to the rod by tightening of the set screw. The
retention member will spontaneously rotate to the appropriate
position, eliminating any possibility of cable loosening or
slippage along the implantable rod, and reducing cable stress or
kinking. The connector is firmly held by the reliable action of a
set screw or other similar lock member for firmly affixing the
connector and rod together in the desired position.
It thus becomes possible to compress or distract bone portions as
the surgeon may desire by the following method:
One places a surgical rod in the patient, and also places wire or
cable around the bone portions which are to be compressed or
distracted. One then tightens the wire or cable into a retained,
tight position including at least one of: (1) sliding the connector
along the surgical rod and (2) rotating the wire or cable engaging
said connector, to position the wire or cable to compress,
distract, or rotate the bone portions in a desired manner. One then
tightly secures the connector to the surgical rod.
By this technique and through the connector of this invention, the
surgeon is provided with significant new options for improved
surgical performance with less difficulty, less need for pedicle
screws, and less expense.
More broadly, this invention relates to a connector for securing
surgical cable or wire (or ribbon, which is intended to be included
in the definition of "surgical cable or wire"). The connector
comprises a connector body having a fitment for receiving or
connecting to a patient-implantable device in firmly locked manner.
The patient-implantable device may be a surgical rod as
specifically shown herein, but it may also comprise other
implantable devices, for example, implantable prostheses for any
joint, such as the hip or shoulder; for example, a prosthesis for
total hip replacement. Also, the patient-implantable device may be
a bone plate, with a connector of this invention providing cable or
wire (or ribbon) connection to any of these patient-implantable
devices for securing a bone, another implantable device, or the
like to the patient-implantable implantable device, or for
supporting the patient-implantable device in a desired position and
retaining it with a cable or wire.
The connector of this invention also has a retention member
comprising at least one of an aperture or a groove, for receiving
the cable or wire and retaining it in a desired position relative
to the implantable device. In the specific embodiments shown, this
can accomplished by positioning the connector at a desired position
along an implantable surgical rod. However, the same principle may
be applied to other implantable devices as desired.
Thus, the cable or wire (or ribbon) can be connected to a
patient-implantable device through the connector of this invention,
which attaches to the patient-implantable device and can be
adjustable in position with respect to the patient-implantable
device, to provide improved flexibility for tubing or use.
In one disclosed embodiment, the retention member described above
comprises an annular groove. In another disclosed embodiment, the
retention member comprises a rotatable head having at least one
aperture therein, as described above.
If desired, the connector of this invention may be directly
attached to a patient-implantable device other than an rod (such as
a bone plate) and may then be attached by cable to a hip or
shoulder replacement prosthesis to assist in support and
positioning particularly of the prosthesis, as may be desired by
the surgeon. Alternatively, the connector of this invention may be
carried on a bone plate or a hip or shoulder prosthesis, and may
support and retain wires that are wrapped around a bone.
DESCRIPTION OF THE DRAWINGS
Referring to the drawings, FIG. 1 is a perspective view of a bone
broken into fragments and having two connectors in accordance with
this invention, shown to be holding cable wrapped around the bone
and retaining it in a desired tension and a desired direction of
the tension, especially adjacent to the cable ends.
FIG. 2 is an enlarged, perspective view of another surgical
situation, showing a single connector of this invention to be
holding both ends of a cable which wraps a bone in a desired
tension and direction of tension.
FIG. 3 is an elevational view, taken partly in section, showing the
FIG. 2 embodiment of the connector of this invention.
FIG. 4 is a sectional view taken along line 4--4 of FIG. 3.
FIG. 5 is an elevational view of the spine of a patient, showing
how an implantable array of rods and connectors in accordance with
this invention can be implanted on the spine to provide cable or
wire retention sites.
FIG. 6 is an enlarged view of a portion of FIG. 5.
FIG. 7 is a further enlarged but inverted view of an implantable
rod, showing one embodiment of the connector of this invention as
an elevational view.
FIG. 8 is an elevational view, rotated 90.degree. about the axis of
the rod, showing the implantable connector of FIG. 7.
DESCRIPTION OF SPECIFIC EMBODIMENTS
Referring to FIG. 1, a broken, multipiece bone 10 is shown to be
secured together with several windings of surgical cable 12, which
surround the broken bone. At the respective ends of wound surgical
cable 12, the cable end portions extend through respective
connectors 14 and 16 by extending through certain apertures thereof
(to be described below) being secured in said apertures by
respective crimps 18 of the known "top hat" type.
The respective connectors 14 and 16 are positioned along an
implantable surgical rod 20. Connector 14 carries a hook 22 of
known design which half surrounds surgical rod 20. Connector 14 is
secured in position by a set screw 24, as shown in greater detail
below.
Connector 16 has a body 25 which defines an aperture 26, through
which rod 20 extends so that rod 20 is completely surrounded by
connector body 25. Here also, a set screw 24 is used to secure
connector 16 to rod 20.
Since the respective connectors 14 and 16 may slide along rod 20 to
essentially any desired position as determined by the surgeon, it
becomes possible to provide tension on the cable from a variety of
directions in a manner substantially easier than in the prior art.
The respective connectors 14, 16 are positioned as desired by the
surgeon. Then, the loops of cable 12 may be tensioned in a
conventional manner with a known tensioner, and the crimps 18 may
be applied, to consequently apply a desired tension to the wound
cable from desired directions depending on the positioning of the
respective connectors 14, 16 along rod 20. Connectors 14, 16 are
secured to rod 20 at any time desired by tightening of each
respective set screw 24, for solid securance between each connector
14, 16 and surgical rod 20, with the consequence that the
respective ends of cable 12 are solidly secured to surgical rod 20
as well.
In this embodiment, the respective connectors 14, 16 each carry a
retention member 28 in ring form, of a design disclosed more
specifically below. The ringlike retention member 28 can freely
rotate, so that during the step of tensioning of cable 12, they
rotate to the optimum position, assuring that no subsequent
slippage of the cable can take place after tensioning, at
least at the site of connection of the cable and connectors 14,
16.
Referring to FIGS. 2-4, connector member 16 is again specifically
shown, carried on implantable surgical rod 20, which is positioned
adjacent to another bone 10a. The design of connector 16 is
identical in both FIGS. 1 and 2, and similar to the design of
connector 14 except for the single difference of the C-shaped hook
22 in the case of connector 14, rather than the fully enclosed
aperture 26 as is found in connector 16. Connector 16 is shown to
have connector body 25, defining the complete aperture 26 discussed
above, which surrounds and retains implantable surgical rod 20.
Body 25 carries lock member 24, specifically a set screw, for
firmly affixing connector 16 and rod 20 together in a desired
position along the rod. Such set screws are conventional, having
threads 30 which engage corresponding threads of body 25 as
particularly shown in FIG. 3, so that the set screw 24 may firmly
and forcefully press against rod 20 when it is desired to secure
connector 16 in place. Set screw 24 also carries, in this
particular embodiment, a hexagonal hole 32 into which the tip of an
Allen wrench can fit, to conventionally advance the set screw into
securing relation with rod 20.
Set screw 24 carries an outer head which defines an outwardly
extending retention flange 34, which in this embodiment extends 360
degrees around the set screw, but other types of flanges can also
be suitable. One purpose of retention flange 34 is to retain the
ring-like retention member 28, which is carried on connector 16
(and connector 14) in a rotatable manner as particularly shown in
FIG. 3. Ring-like retention member 28 can rotate around set screw
24, being retained on one side by connector body 25 and on the
other side by flange 34.
Retention ring 28 is shown to define a pair of holes 36, which
extend completely through retention ring 28 to provide retentive
access for cable 12a.
Accordingly, as particularly shown in FIG. 2, cable 12a may pass
around bone 10a as desired by the surgeon for the best retention
thereof. Cable 12a may also pass through one of holes 36 of
connector 16. One end of cable 12a may be secured into a loop,
being held by a conventional crimp 40, with the loop 42 surrounding
another length of cable 12a which is secured by a conventional
top-hat crimp 44, or other crimp as may be desired. Before crimp 44
is crimped into its retaining configuration, a conventional
tensioner may be used to obtain the desired tension, following
which crimp 44 is crushed with a conventional crimper, and any
remaining cable projecting from the outer end of crimp 44 may be
cut away.
Thus, the direction of cable tension against bone 10a may be
controlled by the desired positioning of connector 16 on rod 20.
When the desired positioning is achieved, set screw 24-may be
tightened using hexagonal aperture 32 and an Allen wrench. The
magnitude of the tension on cable 12a may be controlled in the
conventional manner using a tensioner.
Thus, both the direction and the magnitude of tension on bone 10a
applied by cable 12a can be more precisely controlled than in the
prior art, with greater ease, speed, and reduced expense.
Referring to FIGS. 5 through 8, another embodiment of connector 50
for securing surgical cable is shown. Connectors 50 each have a
connector body and an aperture, as in the previous embodiment,
through which an implanted surgical rod 52 extends. A set screw 54
having a hexagonal socket for receiving an appropriate wrench may
be used to secure by tightening the connector 50 to implantable rod
52. Thus, as in the previous embodiment, connector 50 can slide up
and down the implantable rod 52 to a desired position which can be
determined during the surgery. Then, when the desired position is
reached, set screw 54 may be tightened to permanently secure
connector 50 into the desired position.
As particularly shown in FIGS. 5 and 6, surgical rod 52, and
companion surgical rod 56, may be emplaced along the spine 58 of a
patient. Various wires 60 may be attached, being wrapped around
vertebra 62, (FIG. 6) with a portion of each wire resting in a
portion of annular groove 64 in connector 50 for retention of the
wire, which is formed into a loop with a twisted end 66. Thus, wire
60 is held in a desired position relative to the bone, and may be
pulled in any of a variety of directions depending upon the desired
positioning of its connector 50 on rod 52.
It can be seen that connectors 50 also carry a second annular
groove 68 (FIG. 7) which occupies a plane perpendicular to annular
groove 64, with groove 68 surrounding set screw 54. If and as
desired, a cable or wire can be emplaced in annular groove 68 as
well as, or as a replacement for, the emplacement of such a wire in
annular groove 64. This can be done at the discretion of the
surgeon, and gives him a wider range or choices and directions for
the securance of surgical wire or cable between connector 50 and a
bone or another patient-implantable device as described above.
The connectors of this invention may be made of any desirable
material, particularly surgically implantable metals of types which
are known and reliable for permanent implantation use.
Other conventional connectors such as screw posts 70 and screw
connectors 72, 74 may be used to emplace the respective implantable
rods 52, 56 during the surgical procedure. The patient is then
closed up for convalescence, with the connectors of this invention
reliably holding the wire or cable, in turn, while retaining bone
or another surgical implantable device under tension from a desired
direction, which is controllable depending upon the position of the
connector of this invention on rod 20 or 52, for greater
flexibility of choice on the part of the surgeon, leading to better
clinical outcome.
The above has been offered for illustrative purposes only, it is
not intended to limit the scope of the invention of this
application, which is as defined in the claims below.
* * * * *